ORIGINAL RESEARCH PAPER Volume-7 | Issue-5 | May-2018 | ISSN No 2277 - 8179 | IF : 4.758 | IC Value : 93.

98

INTERNATIONAL JOURNAL OF SCIENTIFIC RESEARCH

A PROSPECTIVE STUDY ON PATIENTS USING SELF DRUGS IN TERTIARY CARE

HOSPITALS

General Medicine
Dr.J. Kamaraj M.D.,Asst.Prof Of Medicine .Govt Theni Medical College ,Theni.
Dr. S. M.D.,Prof Of Medicine, Karpagam Faculty Of Medical Sciences And Research Institute,
Dharmalingam* Coimbatore-32 *Corresponding Author
Dr. T. Ravikumar M.D.Prof And Hod Of Medicine Govt Medical College And Esi Hospital.Coimbatore .15
Dr. A. M.D., Prof .of Emeritus, The T.N. Dr.M.G.R.Medical University. Chennai.
Muruganathan
Dr. P. Saravanan M.D Asst. Prof. Of Medicine .Govt Madurai Medical College .Madurai.
Dr. S. Sopnajothii M.D.,Asst.Prof Of Medicine .Govt Theni Medical College .Theni
ABSTRACT
Objectives:The objective was to assess the self-medication patterns and drug use behaviour in patients attending medical op in a tertiary care
hospitalsin Tamil Nadu ,South India,
Materials and Methods: A detailed questionnaire designed to assess the self-medication patterns and drug use behaviour and interview technique
was used to elicit the requisite information. Five hundred patients were studied,
Results:Most of the patients were in the habit of keeping the medicines (88%)though only 66% of them were in the habit of using it without any
prescription.
Also it was seen that those patients who were taking self-medication were better educated than those not indulged in self-medication.
Suggestions from friends, advertisement on the television, and newspapers. For most of them the reasons for self-medication were financial
restraints and lack of time to go to the medical practitioner.
Conclusions;The results emphasize the need for comprehensive measures for intervention strategies to promote rational drug therapy by
improving prescribing patterns and influencing self-medication.
KEYWORDS
Drug use behaviour, rational therapy, self-medication

Introduction
Self-medication is defined as the consumption of medicinal products
with the purpose of treating diseases or symptoms, or even promoting
health, without a prescription provided by a medical professional.
The prevalenceof the practice of self-medication depends on many
factors like nature of the disease, educational qualification of the
person, nonavailability of the specialized person (during travelling or
such conditions), etc.
Many part of south India they follow traditional methods first before
going for self medication, They try fasting, not providing any diet, then
give holy ash and prasadham from temples ,then they try house hold
remedies, example they take turmeric boiled with milk for cough with
expectoration but hot water itself is enough. they prepare varieties of
teas with ginger ,or dry ginger,coriander seeds ,pepper, thulasi ,mint
leaves, in house itself called grandma or pattivaiththiyam or house
hold remedies.
and other viral exanthemas,and fever with rash may cause the patient to
increase the morbidity and mortality and prolonged illness spread the
illness to others ,and various complications at times death.
Medical shops in India
There are many medical shops in India not managed by pharmacists
Many medical shop owners starts their carrier as assistant to a shop
keeper their main work is to clean the shop ,they promote after two
month to two years as purchase in charge to bring medicines from
whole sale stockiest to medical shop they learn the art of counter
selling by pattern recognition of drug names and from
dr”s prescription pattern.

Steam inhalation with plain water , for sinusitis or upper respiratory

tract infections, applying lukewarm water in the forehead for fever as
tepid sponging .Putting lemon in the fingers or applying mehanthi
leaves forparanychia,Applying coconut oil or lime for insect
bites,,Applying coconut oil with camphor for pain in the joints, hot
fomentation,Applying turmeric powder, powdered tablets of anything
(antibiotic or analgesic ) or lime for bleeding wounds,Many of them
may not be scientifically proven relives but they are very cheap, easily
available, 24 x7 in the house and preparation does not require any
expertise
For outdoor injuries applying mud, kerosene, powder, sugar, coffee
powder cow dung, leaf extracts from nearby plants will make the
attending surgeons work very tough to clean, to suture or to do dressing
which will ultimately results in infection tissue necrosis or non healing
of ulcers ,even results in amputation if the patient is diabetic or
immuno compromised.
On the other hand not getting treatment for herpes zoster, chickenpox
In one study it was seen that 87% of the patients with cough and cold
initiated medication on their own for getting relief and this percentage
was significantly more in urban people (93.9%) compared to rural
subjects (80.6%).(2)In another survey conducted in Hong Kong, 97%
of the patients practiced self-medication to a variable extent.(3) Self-
medication was found to be significantly low in breast-feeding
mothers (3.2%).(4)
Inappropriate self-medication results in irrational use of drugs,
wastage of resources, increased resistance of pathogens, entails
serious health hazards such as adverse reactions and prolonged
suffering.(5)

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If action is not taken, the danger of drug interactions and side effects
could increase. Safety in self-medication depends on four factors –
drug itself (inherent properties of the drug, dose and its duration),
formulation, information available with all purchases, and patient
compliance.(6)
A number of reasons could be enumerated for the rise of self-
medication. One of the reasons being the increase in chronic diseases
and their incidence has raised from 30% to 80% in the last 40
years.(5,7)
Other reasons which are responsible for self-medication in developing
countries are urge of self-care, feeling of sympathy toward family
members in sickness, lack of health services, poverty, ignorance, mis-
beliefs, extensive advertisement in t.v., use of drugs from informal
sectors such as open markets and quacks , herbal ? natural product?
Organic, ?slimming diets , drugs for incurable diseases, dm,
impotence, Some authors are of the view that self-medication can be
practiced and they consider it appropriate for short-term relief of
symptoms where accurate diagnosis is unnecessary, uncomplicated
cases of some chronic and recurrent disease (medical diagnosis having
been made and advice given).(6)
However, people should be properly educated about the practice of
self-medication in order to prevent the harmful effects caused by the
practice. The increasing self-medication will require more and better
education of both the public and health professionals to avoid the
complications arising from this practice.(8,9)
There has not yet been any systematic research conducted to assess the
prevalence of self-medication in the community. Thus self-medication
in modern pharmaceuticals seems to be a field in which information is
scarce.(7)
To the best of our knowledge there is no research conducted to reveal
the extent of this problem in India. Therefore we believe that this
research may show the magnitude of problem in India so as to initiate
intervention by the concerned authorities and the community as well.
Material and Methods
The population of Tamil nadu has very good access to health facilities.
There are7656 health sub centresmore than 1649 PHC s (reach with in
7 kms),23 medical colleges,30 govt head quarter hospitals 241 taluk
and non taluk hospitals,100 urban phcs,206 eidispensaries, and lot of
charity hospitals , private medicalcolleges and corporate hospitals ,and
a lot of ayushcenters , but even in petty shops analgesics, anti cold , and
alot of carminative mixutres ,cough syrup, in sachets, are available.
A structured and pretested questionnaire was used to collect the
information. self-medication was practiced, cautions taken during
self-administration of the drugs, and use of other type of medications
other than Allopathy.
Results
A total patientssurveyed, out of which proformas were filled by 78
percent were found to be having drugs in their house but only 63%
practiced self-medication.
Mis used drugs
analgesics – 91% (paracetamol 46%) (diclo/aceclo18%)(brufen 21)
antacids – 64%,antibiotics – 13%nutritional supplements – 23%,
cough syrups – 31%, antispasmodics – 14%,topical applications –
34%others – 28%
The correct indications of the stored drugs were known to 28% and
partial indications to 53%. However 19% of them had wrong
impression about the indication of the stored drugs. Many of them
stored on the top of the refrigerator which is hot and destroy the drug
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ISSN No 2277 - 8179 | IF : 4.758 | IC Value : 93.98
immediately
The instructions by the physicians regarding dose, frequency, and
duration of treatment were strictly adhered to by 41% patients Only
49% were aware of the fact that the drugs can cause adverse effects if
taken without medical advice.Many of them get the (?)knowledge
about the the drug from face book and whatsapp unread, un analysed,
just forwarded messages almost all are wrong .
Only 44% used proper measures for liquid preparations. Seventy-one
percent of the patients were of the opinion that self-medication is not
justified but felt that it had to be continued because of financial
constraints. (.paying fees to doctors)
Discussion
Self-medication is a significant problem in relation to the rational use
of drugs and unwanted adverse effects caused by the drugs. The
prevalence of self-medication in this study was found to be 63%
compared to that of 27.6% in a study done in Jimma Town,(10) 30% in
a study done in Mexico,(9) and 97% in a study conducted in Hong
Kong.(3) It was also found that prevalence of self-medication was
Self-Medication Patterns and Drug UseBehaviour in found to be
higher in well-educated patients compared to the illiterate or people
with low education. One of the studies published by an Indonesian
journal also highlighted the fact that education level is the dominant
factor for the practice of self-medication.(11) A majority of the patients
practiced self-medication based on their previous prescription.
Another reason for this wide practice was advertisements on the
television. In addition to this, friends also constituted 17% of the
proportion who guided this irrational practice.
Similar results were also seen in the studies done in Brazil and France.
In one of the studies conducted in the Hong Kong the reasons for self-
medication included the conditions like musculoskeletal pain, minor
burns or bruises, gastrointestinal upset, headache, sore throat, skin
problems, cough, and dyspepsia.(3)
Also it was seen in this study that a large number of people were not
aware of the potential damaging nature of the different medications
self-administered by them
There is an alarming deficiency in the patients' knowledge of the
possible side-effects of selfmedication; they should therefore be
warned about the danger.”(3)
However some authors consider that self-medicationis appropriate.(6)
Also World Health Organization is nowadays promoting the self-
medication for trivial diseases to save the time and resource wasted in
treating the minor diseases.(7)
1 Do you use any medications without medical advice? 212 388
What is the motivation/Information Source for Self-
2 163 337
Medication?
3 What are the cautions you observe regarding Self- 111 389
Medication?
4 Have you got knowledge regarding the patient 241 259
information leaflet?
Have you got knowledge regarding prescribing
5 information, e.g., dose, duration of treatment, 289 211
interaction with food or other drugs?
Do you use any other type of medicines other than
6 56 444
allopathic medicines?
7 How do you decide the dose, frequency and duration 245 255
of the drug use undertaken by you?
8 Do you check the expiry date on drug preparations 401 99
used by you?
9 Do you feel that self-medication is not justified and 446 54
you should not take it
10 Are you aware of the adverse effects of drugs used 411 89
without doctor's advice?
11 Which measures do you use for liquid preparations? 265 235
12 Do you keep medications in your house? 289 211
Do you have a different place for keeping
13 312 188
medications? Where?
14 Is your medicine closet out of reach of children? 242 258
Do you keep medications in a classified manner, e.g.,
15 234 266
pain relievers, Antidiarrheal?
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In this study along with studying the self-medication some guidelines

were also given for the proper use of medicines and their storage and
these guidelines are provided

Conclusion:
This study shows that self-medication is quite prevalent among
thepatients belonging to the middle income group and that most of
them are educated too. A majority of patients are not aware of the fact
that adverse effects can occur if medication is taken without doctor's
advice and it is necessary to check the expiry date of medicine.

So more and better education of both the public and health

professionals is required to avoid complications arising from this
practice.

Source of Support: Nil

Conflict of Interest: nil

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